Correct Answer: A

Rationale: Cinacalcet is a medication that can lower calcium levels, leading to hypocalcemia. Monitoring for signs of low calcium levels such as muscle cramps, tingling sensations, and abnormal heart rhythms is crucial to prevent complications in clients with chronic kidney disease.

Correct Answer: D

Rationale: Vancomycin is known to be nephrotoxic, which means it can cause damage to the kidneys. Therefore, clients receiving Vancomycin should be closely monitored for signs and symptoms of acute kidney injury (AKI) to ensure early detection and intervention if necessary.

Correct Answer: A

Rationale: Amlodipine can cause peripheral edema, so monitoring for signs of swelling is important.

Correct Answer: D

Rationale: The correct answer is D. Losartan is prescribed for the treatment of hypertension. The desired effect of losartan is to reduce blood pressure. Therefore, a reduction in blood pressure from 160/90 to 130/80 mm Hg indicates that the desired effect of the medication has been achieved. Choices A, B, and C are not specific effects of losartan and do not directly relate to the expected outcomes of this medication.

Correct Answer: C

Rationale: The correct instruction for a client prescribed methotrexate is to avoid sunlight while taking this medication. Methotrexate can increase sensitivity to sunlight, leading to skin reactions, so clients should limit sun exposure and use protective measures like sunscreen and clothing coverage to prevent adverse effects.